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How can we better help iron miners avoid mesothelioma?

Madeleine Pick

After months, John finally received a diagnosis: malignant mesothelioma. His doctor answered the question on his mind. “Most people with your condition live for about a year.” Then the doctor asked about any past asbestos exposure and listed some possibilities, including iron mining. John’s mind was reeling, and he felt a pit in his stomach. He had been an iron miner for 30 years. It was his livelihood and the primary source of income for his family. His livelihood led to his fatal diagnosis.

Nearly everyone has had a personal experience with cancer, and many are frustrated by the seemingly random nature of who gets the unlucky diagnosis. However, malignant mesothelioma is different. Mesothelioma is directly linked to asbestos inhalation, which is found in various materials and naturally occurs in many iron and taconite mines in northeastern Minnesota. Because of this relationship, miners on the Iron Range have a risk of developing mesothelioma that is three times higher than the state average.

A long latency period

There are a number of issues contributing to this problem that disproportionally affect miners. Mesothelioma has a latency period of about 20 to 40 years or beyond, meaning that patients are typically not diagnosed until decades after they have been exposed to asbestos. Earlier detection may lead to better survival rates among mesothelioma patients, or possibly prevent the disease from manifesting altogether given an individual’s known exposure.

This problem is difficult to tackle given other factors that are not directly related to health. First, iron mining has historical and economic importance in these communities. For many towns, mining is one of the top industries for employment. The economic importance of the mining industry is just another reason to keep our miners healthy. We know the connection between asbestos and mesothelioma, and yet the number of deaths continues to grow. In fact, St. Louis County and neighboring Carlton County are within the top 25 counties nationwide for deaths related to mesotheliomam placing 21st and 3rd, respectively.  

So, what can Minnesotans do to stop this problem and keep miners and their families healthy? First, as with any occupational hazard, it’s important to make sure those who are at risk understand what the risks are and why they should follow health and safety protocols. Second, disease research may offer new developments in screening and treatment options that can save lives. For years, mesothelioma has been overlooked relative to other cancer research. As an example, cervical cancer has a similar death rate and receives about eight times the amount of funding from the National Institutes of Health (NIH) and the National Cancer Institute (NCI) compared to mesothelioma.

Establish an ongoing registry

Research funding can help shape a better future for mesothelioma patients, but it will be too late for those who are already diagnosed or have been exposed and could be diagnosed in a number of years. I would propose establishing a state registry of iron miners, similar to the Minnesota Iron Miners cohort used in a study conducted by the Minnesota Department of Health, but this new registry would be ongoing. The uses of the registry would also stretch beyond a single study. This would be an opportunity to partner with organizations like the Iron Mining Association of Minnesota in developing an occupational health program to provide disease education and detect mesothelioma earlier while also building on existing regulations and practices.

John has a tough battle to face with his mesothelioma diagnosis, particularly given the average life expectancy. In addition, he is also concerned for his friends and family in the mining industry who are also at risk of developing mesothelioma. If you drive through the mining towns of northeastern Minnesota, you’ll likely see yard signs reading “we support mining” and “mining supports us.” The rich history and pride is clear – but isn’t it time we step up to truly support our miners by protecting their health?

Madeleine Pick is a Master of Public Health student in Public Health Administration and Policy at the University of Minnesota School of Public Health.

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Comments (3)

Miners

A couple of things:

Has it actually been established that the naturally occurring material in the mines is causing mesothelioma? I know defendants in asbestos litigation have been arguing that for years, but I thought it was inconclusive. Most or all of the asbestos in industrial products is now gone.

The reason more money is spent on cervical cancer is because those diagnosed are much younger. The long latency period means most mesothelioma victims are already in their 60s or 70s, and have often lived lifestyles (i.e. heavy smoking) that don't lead to long life expectancies anyway. Maybe that's not fair, but its how things work. There have been a lot of developments in prevention and treatment for cervical cancer (maybe that's because of the money, not vice versa) while mesothelioma is pretty grim.

Another question...

Cancers like this are all about exposure to the carcinogen, so the only way to avoid it is to avoid exposure... I don't see that fact being clearly explained here.

Another problem is the population itself, someone who's worked in the mines for 30 years is far more likely to have been exposed than someone who started two years ago, so if we want to talk about prevention we have to narrow the focus to those who can avoid the exposure, those who have already been exposed will continue to develop the disease... this is why deaths will continue to rise. We wouldn't expect the fatality rate to decrease simply because we recognize the disease, on the contrary we would expect exactly what we're seeing, those who have been exposed will continue to develop the disease.

The link with asbestos has been clearly established. I think the cases we're seeing are due to past exposure, which is why this is kind of a confusing article, the author seems to be suggesting that past exposure can be mediated somehow and disease can be avoided, I don't think there's any science behind that. Unfortunately it's just a wait and see kind of thing and we'll see an increase in deaths as the population ages.

Mesothelioma is Idiopathic

The projected 40% increase in deaths from drug abuse, alcoholism and suicide is a conservative solution to idiopathy.